Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Am J Perinatol. 2013 Apr;30(4):267-73. doi: 10.1055/s-0032-1323589. Epub 2012 Aug 8.
To assess the prevalence and risk factors of cardiovascular disease (CVD) among younger women by pregnancy history.
Cross-sectional study using 1999 to 2006 National Health and Nutrition Examination Survey including women aged 20 to 64 years who had delivered at least one infant (n = 4820). Women self-reported pregnancy history and a clinician diagnosed CVD; CVD risk factors included hypertension (mean systolic blood pressure [BP] ≥140 mm Hg or mean diastolic BP ≥90 mm Hg, or currently treated), high cholesterol (total cholesterol ≥240 mg/dL or currently treated), diabetes (self-report or hemoglobin A1c ≥6.5), and smoking (self-report or cotinine-verified). Multivariable logistic regression was used to assess the association between pregnancy history and CVD.
Of the women we studied, 4.6% had CVD; 3.1% had delivered a term low-birth-weight infant (TLBWI). Women with a history of TLBWI had an adjusted odds ratio (AOR) of 2.07 (95% confidence intervals [CI] 1.08 to 3.99) for CVD compared with women without a history of LBWI. Adjustment for hypertension and high cholesterol mildly attenuated the association (AOR 1.85, 95% CI 0.89 to 3.83). Among women without CVD (n = 4555), 23.1% with a history of TLBWI had two risk factors compared with 14.0% of those without a history of LBWI (p = 0.0016).
Women with a history of TLBWI should be informed of a possible increased risk of CVD and encouraged to receive screenings as recommended.
通过妊娠史评估年轻女性心血管疾病(CVD)的患病率和危险因素。
采用 1999 年至 2006 年全国健康与营养调查的横断面研究,纳入至少分娩过一名婴儿的 20 至 64 岁女性(n=4820)。女性自我报告妊娠史,临床医生诊断 CVD;CVD 危险因素包括高血压(平均收缩压[BP]≥140mmHg 或平均舒张压[BP]≥90mmHg,或正在治疗)、高胆固醇(总胆固醇≥240mg/dL 或正在治疗)、糖尿病(自我报告或血红蛋白 A1c≥6.5)和吸烟(自我报告或可替宁验证)。多变量逻辑回归用于评估妊娠史与 CVD 之间的关联。
在所研究的女性中,4.6%患有 CVD;3.1%分娩过足月低体重儿(TLBWI)。与无 LBWI 史的女性相比,有 TLBWI 史的女性 CVD 的调整后优势比(AOR)为 2.07(95%置信区间[CI] 1.08 至 3.99)。调整高血压和高胆固醇后,该关联略有减弱(AOR 1.85,95% CI 0.89 至 3.83)。在无 CVD(n=4555)的女性中,有 TLBWI 史的女性中有 23.1%存在两个危险因素,而无 LBWI 史的女性中有 14.0%(p=0.0016)。
有 TLBWI 史的女性应被告知 CVD 风险可能增加,并鼓励其按照建议接受筛查。